Health Care Checkup: November 19, 2021

Health Care Checkup

November 19, 2021

THE BIG PICTURE

After months of back-and-forth negotiations on the House’s $1.68 trillion budget reconciliation bill, the Build Back Better (BBB) Act, the House voted this morning in a vote of 220-213 to pass the legislation. No House Republicans voted in favor of the bill, and only one Democrat opposed it. The BBB includes billions of dollars in funding to make substantial improvements to the federal health care system, the education system, and climate change initiatives.

The BBB will expand Medicare to include hearing coverage, permit Medicare to begin negotiating the prices of certain prescription drugs, provide workers with up to four weeks of paid leave to deal with life events such as the birth of a child or a serious illness, expand home-based care services, extend American Rescue Plan subsides that make health insurance more affordable through 2025, expands the ACA’s premium tax credits to below 100 percent of the federal poverty level to cover those in the Medicaid gap, and provide mothers with postpartum Medicaid coverage during the year after they give birth.

On Thursday, CBO released the final estimate, which predicts that the bill will cost $1.68 trillion over a ten-year period. This number is lower than the previous prediction of $1.75 trillion by the White House. The bill, which is a major part of President Joe Biden’s social and economic agenda, will now head to the Senate, where it will almost certainly go through revisions. Democratic Senate Leader Chuck Schumer hopes to pass BBB through the Senate by the end of the year. However, it is unclear how long potential revisions will take. Resources on the bill can be found in our “deep dive” section below.

Also this week, the House Energy and Commerce Committee held a markup of eight health-related bills. Each bill was reported favorably by voice vote. The bills are listed below in our “deep dive” section.

What to Expect Next Week: Both the House and Senate will be out of session for the Thanksgiving holiday.

DEEP DIVE

House Passes Social Infrastructure Bill

After months of back-and-forth negotiations on the House’s $1.68 trillion budget reconciliation bill, the Build Back Better (BBB) Act, the House voted on Friday, November 19, in a vote of 220-213 to pass the legislation. No House Republicans voted in favor of the bill, and only one Democrat opposed it. The BBB includes billions of dollars in funding to make substantial improvements to the federal health care system, the education system, and climate change initiatives.

Specifically, the BBB will expand Medicare to include hearing coverage, permit Medicare to begin negotiating the prices of certain prescription drugs, provide workers with up to four weeks of paid leave to deal with life events such as the birth of a child or a serious illness, expand home-based care services, extend American Rescue Plan subsides that make health insurance more affordable through 2025, and provide mothers with postpartum Medicaid coverage during the year after they give birth. The legislation also includes universal pre-kindergarten, an extension of the child tax credit through 2022, and the creation of a Civilian Climate Corps to combat climate change.

The House’s vote on BBB was delayed earlier in the fall, first because of its linkage to the bipartisan infrastructure legislation, and later because moderate Democrats said that they would not vote for the bill until the Congressional Budget Office (CBO) released a final cost estimate of the bill. On Thursday, CBO released the final estimate, which predicts that the bill will cost $1.68 trillion over a ten-year period. This number is lower than the previous prediction of $1.75 trillion by the White House. CBO predicts that $1.2 trillion will be generated by changes to the tax code. Additionally, greater Internal Revenue Service (IRS) enforcement of tax fraud should result in $207 billion in revenue. CBO predicts that BBB will result in a $160 billion deficit.

The bill, which is a major part of President Joe Biden’s social and economic agenda, will now head to the Senate, where it will almost certainly go through revisions. Democratic Senate Leader Chuck Schumer hopes to pass BBB through the Senate by the end of the year. However, it is unclear how long potential revisions will take. Democratic Senators will likely pursue changes in the areas of prescription drug pricing reform, paid leave, and other areas. It is also likely that amendments will be taken to the Senate floor and that procedural changes will occur from the Byrd rule.

Build Back Better Resources:

CBO final cost estimate can be found here.
Section-by-section breakdown of the legislation can be found here.
Text of bill can be found here.
W&M fact sheet.
E&C fact sheet.
Ed & Labor fact sheet.

Highly Anticipated Cures 2.0 Legislation Unveiled

On Tuesday, House Representatives Diana DeGette (D-CO) and Fred Upton (R-MI) introduced the highly anticipated, bipartisan Cures 2.0 legislation. The bill seeks to make investments in innovative therapies and technologies to cure “the world’s most difficult diseases.” Cures 2.0 would create the Advanced Research Projects Agency for Health (ARPA-H), which would be a new agency within the National Institutes of Health (NIH). ARPA-H would be tasked with finding new cures and treatments to diseases such as cancer, diabetes, and ALS. Additionally, Cures 2.0 would expedite the approval process of new treatments and technologies available to Medicare beneficiaries, increase access to telehealth services for Medicare and Medicaid beneficiaries, provide resources for at-home caregivers, make clinical trials more diverse, and provide patients with more tools to navigate their illness(es). While DeGette and Upton had hoped to get the legislation passed before the end of the year, they said that it may not pass until next year. Upton said, “We're now going to try to focus on the fast track and work with our Senate colleagues, but we may not meet the deadline before the end of the calendar year unless we really put in some long nights, which somehow, I think we're going to be doing even without this bill.” The Cures 2.0 Legislation can be found here, and the section-by-section summary can be found here.

CMS Announces 2022 Premium, Deductible, and Coinsurance Amounts for Medicare Parts A and Part B

Late last week, CMS announced that the monthly premium for Medicare Part B enrollees will be $170.10 in 2022, an increase of $21.60 from the 2021 rate. The Medicare Part B annual deductible will be $233 in 2022, an increase of $30 from the annual deductible rate in 2021. The Medicare Part A inpatient hospital deductible will be $1,556 in 2022, which is an increase of $72 from the prior year. CMS attributes the increased prices to the higher rate of utilization across the health care system, Congress’ decision to lower the premium rate in 2021 (which CMS said resulted in a $3.00 per beneficiary per month increase in the Medicare Part B premium to continue the program through 2025), and the contingency that Medicare may begin covering the expensive Alzheimer’s drug, Aduhelm. The press release can be found here and the fact sheet can be found here.

Biden Administration Releases Interim Final Rule to Improve Transparency of Prescription Drug Prices and Medical Costs

On Wednesday, CMS issued the fourth rule in a series of rules that the agency is issuing to implement the No Surprises Act and the Consolidated Appropriations Act. The interim final rule seeks to lower health care costs by requiring insurers to report on prescription drug prices and health coverage costs. While the new requirements will apply to data from the 2020 calendar year, CMS reports that enforcement of the new requirements will be deferred until December 27, 2022, to “give regulated entities time to come into compliance.” CMS is seeking comments on the interim final rule, which must be submitted by 5:00 PM on January 24, 2022. The press release and fact sheet can be found here and here.

Pfizer Seeks EUA for COVID-19 Oral Antiviral

On Tuesday, Pfizer asked the Food and Drug Administration (FDA) to grant an emergency use authorization (EUA) for its oral antiviral drug, PAXLOVID. The antiviral is used to treat mild to moderate cases of COVID-19. If authorized, PAXLOVID would be the first oral antiviral of its kind to combat COVID-19. Clinical data from a study of the drug showed it had an 89% reduction in the risk of COVID-19-related hospitalization or death “in non-hospitalized high-risk adults with COVID-19.” Pfizer’s press release can be found here.

FDA Authorizes Pfizer and Moderna COVID-19 Vaccine Boosters for all Adults

On Friday, the FDA authorized boosters of the Pfizer and Moderna COVID-19 vaccines for all adults. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices is slated to convene later Friday to discuss further clinical recommendations. The FDA’s announcement can be viewed here.

House Energy and Commerce Committee Holds Markup on Eight Health Bills

On Wednesday, the House Energy and Commerce Committee held a markup of eight health-related bills. Each bill was reported favorably by voice vote. The bills can be found below:

H.R. 5561, the Early Hearing Detection and Intervention Reauthorization Act. Reauthorizes a program for early detection, diagnosis, and treatment regarding deaf and hard-of-hearing newborns, infants, and young children.
H.R. 5487, the Stillbirth Health Improvement and Education for Autumn Act of 2021. Improves research and data collection on stillbirths.
H.R. 1193, the Cardiovascular Advances in Research and Opportunities Legacy Act. Expands research on valvular heart disease and its treatment.
H.R. 1667, the Dr. Lorna Breen Health Care Provider Protection Act. Establishes grants and requires other activities to improve mental and behavioral health and prevent burnout among health care providers.
H.R. 3320, the Allied Health Workforce Diversity Act of 2021. Allows the Department of Health and Human Services to provide grants to accredited education programs to increase diversity in the physical therapy, occupational therapy, respiratory therapy, audiology, and speech-language pathology professions.
H.R. 4555, the Oral Health Literacy and Awareness Act of 2021. Amends the Public Health Service Act to authorize a public education campaign across all relevant programs of the Health Resources and Services Administration to increase oral health literacy and awareness.
H.R. 5551, the Improving the Health of Children Act. Amends title III of the Public Health Service Act to reauthorize the National Center on Birth Defects and Developmental Disabilities.
H.R. 3537, the Accelerating Access to Critical Therapies for ALS Act. Establishes grant programs to address neurodegenerative diseases, such as ALS.